| NPI | 1427404565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2022-01320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 279204) |
| Enumeration Date | 2016-05-08 |
| Last Update Date | 2022-09-09 |